Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $4,265.80 / $16,218.10	Facility		$630.96	$4,265.80	$16,218.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $1,513.56 / $7,244.36	Professional		$354.81	$1,513.56	$7,244.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,096.48 / $4,466.84	Professional		$446.68	$1,096.48	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,344.23 / $12,022.64	Facility		$630.96	$2,344.23	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,905.46 / $4,168.69	Professional		$630.96	$1,905.46	$4,168.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,818.38 / $3,090.30	Facility		$2,089.30	$2,818.38	$3,090.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,089.30	Facility		$1,995.26	$1,995.26	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,122.02 / $3,715.35	Professional		$457.09	$1,122.02	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $9,120.11 / $17,378.01	Facility		$6,456.54	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,047.13 / $3,388.44	Professional		$467.74	$1,047.13	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $11,748.98 / $19,054.61	Facility		$3,311.31	$11,748.98	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,412.54 / $3,715.35	Professional		$467.74	$1,412.54	$3,715.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $562.34 / $2,818.38	Professional		$346.74	$562.34	$2,818.38